Getting to the heart of travel healthcare.

A podcast hosted by Sunny & Matt

Podcast Transcript

Dissecting the Healthcare Job Market

January 8, 2020

TRANSCRIPT

Voice Over: Welcome to Cardium, from Aureus Medical. The podcast that gets to heart of travel healthcare and asks, what's your why? With each episode, we explore the topics and issues that impact healthcare professionals in the fields of nursing and allied health. Now, here are your hosts, Sunny and Matt.

Matt: Welcome to Cardium. If you're a subscriber, welcome back. Thank you for being part of the Cardium family. If you're a new listener, thanks for stopping by. We hope you enjoy the podcast today, and we would love for you to subscribe so you can enjoy future podcasts. Joined with me as always is Sunny. Hi, Sunny.

Sunny: Hello, hi.

Matt: How are you doing today?

Sunny: I'm doing great, thank you, how are you?

Matt: I'm doing really well. I'm really well. You know, Sunny, there's a belief that you never know who you're going to meet, especially when you're trying to put your best foot forward, and never more so this could be true when just this last November, I had the fortunate circumstance to attend the Staffing Industry Analysts' Conference for healthcare in Las Vegas. I briefly had a conversation with today's guest.

Sunny: That's exciting.

Matt: It was. It was really exciting for me, because our guest has been in the industry for a long time, and has done a lot of different things throughout her career. But she's working for Staffing Industry Analysts today, and her knowledge about our industry is super deep. She just brings so much knowledge and so much that she's done, that I was very fortunate that I was able to talk with her, and I think we are fortunate that we can bring her on today as a guest.

Sunny: Yeah, and especially to our listening audience, because for those that are not familiar, she's going to be able to kind of give us background on how important they are to our travelers. But also, what kind of knowledge and baselines and trends and as well as research that they give us. Amy Chang is a recognized strategic expert in the healthcare staffing industry, and is currently the healthcare analyst for the Staffing Industry Analysts. From 2009 to 2016, Amy was VP of Strategy and Investor Relations for AMN Healthcare. After joining AMN in 2002, she led the strategic planning operations analysis and market research functions, and also served in interim operational leadership roles.

Sunny: Amy began her career as an auditor CPA with KPMG, after earning her Bachelor of Science in business administration from UC Berkeley. After earning her MBA from UC Berkeley, she was a strategy consulting manager at Mitchell Madison Group, where she worked with Fortune 500 clients, so welcome!

Amy: Hello, it's awesome to chat with you and with Sunny and Matt today, thanks for having me.

Matt: Thanks for joining us, Amy, it's good to see you again.

Sunny: Thanks, yeah. I'm actually kind of excited, because I'm kind of a geek, and I read a lot. Just to have you come and join us, and I read a lot of SIA articles, and actually kind of be a part of that. I love to do research and just to have someone from SIA, and to have you here. I'm really, really, really excited. So thank you, so I know I can't actually touch you and have an autograph from you right now, but I'm pretty geeking out right now.

Matt: You are pretty starstruck. This is good. This is good.

Amy: Just so you know, I'm a secret nerd as well. I think we probably resonate that way, but it's an honor to be on your podcast. I've been in the healthcare staffing industry for a long time, I'm a huge fan of the industry, and I have so much respect for all of the clinicians that are out there serving our healthcare systems every single day.

Sunny: That's awesome. I don't think people realize how much information and analytics go into staffing. Before we go any further, can you give us a little background on who and what is Staffing Industry Analysts?

Amy: Yeah, so the Staffing Industry Analysts is, it's considered the marquee research company that covers the entire staffing industry. Both in the US and globally. A portion of that is the healthcare staffing industry here in the US, and so I specifically cover the healthcare staffing segment, and I work with all of the SIA members, such as your company. We do benchmarking studies, so we can better understand what's happening in the various segments. Like travel nursing is a segment, allied health staffing is a segment. So is per diem, and then there's also locum tenens. We do a lot of benchmarking and research for those segments.

Sunny: Okay.

Matt: Fantastic, Amy. I think when you and I met last November in Las Vegas, that really is the pinnacle for healthcare staffing, what SIA covers as far as healthcare staffing. Maybe you can give our audience kind of today, what is the state of healthcare staffing at present? Kind of maybe the job market support the nurses and allied health professionals, and kind of go into that a little bit?

Amy: Yeah, it's a great time to be in the healthcare staffing industry. It's projected to be an $18.1 billion revenue generating industry in 2020, and the largest segment is travel nursing, at $5.8 billion, followed by allied health staffing at $4.3 billion. Locums is not too shabby at $4.2 billion, and per diem nursing is at $3.8 billion. But you can see the majority is still nursing, right, which is not a surprise, because there's 3.1 million employed nurses, registered nurses in our country today. Not only is it a great time to be in the healthcare staffing world, it's a great time to be a clinician in the United States. If you look at the Bureau of Labor Statistics for the US, they recently published their new projections for the next decade.

Amy: Over the next decade, ending 2028, the BLS projects that for example registered nurse employment is going to grow 12%, and there'll be 3.4 million registered nurses in our country. That's pretty exciting, because actually for the entire US, US employment is supposed to grow by 8.4 million. But just so you know, healthcare and social assistance is going to make up 3.4 of that 8.4 million, so our industry, being in healthcare, is going to make up 40% of the job growth in our country over 10 years. So it's an exciting time, I think, to be a clinician. The physician employment is going to grow by 7% over the decade, to about 812,000. These are pretty significant numbers, and obviously these clinicians have a very significant impact in healthcare, because if you look at a hospital's operating budget, probably over half of its operating budget is made up of human capital, right, which is made up of these clinicians. Clinicians make up a very, very impactful role in our healthcare system.

Sunny: You talk about ... sorry, Matt. You talk about this growth, and the huge amount of jobs that we're foreseeing. We know for nurses, we've been hearing for years that the reason why we're having this opening is because nurses are getting older and they're retiring. The openings, but not a lot of people are going ... not enough students are going into this, right? Can you foresee also what other reasons are causing this growth in the market?

Amy: Yeah, it's very interesting, right, because ... one of the major drivers of healthcare in general, so how much healthcare gets delivered in our country. Believe it or not, having a stable economy contributes to that a lot. We've had an unprecedented number of years of stable growth in our country over the last decade, and so that's been very helpful to growth in healthcare. As well as access to healthcare, so Obamacare, although it was implemented many, many, many years ago now, it really did give more people access to healthcare. There's more insurers. That really has helped to drive growth in healthcare over the years. That's also compounded by the fact that our population in the US is growing in general. But it's also aging, which is what you sort of alluded to.

Amy: The interesting part about an aging population is that it impacts us in two different ways. One is that when you have an aging population, they tend to use more healthcare services per person, as they age their acuity in health condition can be a little bit more intense and severe. But then we also are going to see more and more clinicians retiring, right, because they're sort of aging at the same time. It's created a lot of tightness in our job market. An example of that is, right now in our country, we've got a very low unemployment. In October of this year, of 2019 in the US, the BLS reported that we were at a 3.6% unemployment rate in our country, but it's even lower in healthcare.

Amy: Registered nurses have a 1.1% unemployment rate-

Sunny: Wow.

Amy: In the third quarter of 2019, if you can believe that. Physical therapists, even despite some of the short term disruption they've had in their industry, they were reported at a 1% unemployment rate, and physicians were at a 1.4% unemployment rate, which feels sort of unbelievable. That's likely contributed to this tightness that we've been feeling in healthcare in the job market.

Sunny: Mm-hmm (affirmative). It's almost hard to believe that when you're dealing in the travel industry, because when you're working with clients, they might feel others. They might be like, is there only a 1% unemployment rate? Because of the need that we're feeling. But I think that's probably more geographically based than other, wouldn't you say?

Amy: It is. It is geographic, and a question that you had just asked previously was around, is our country producing enough nurses?

Sunny: Yeah.

Amy: Interestingly, if you look at the last four years from 2015 to 2018, each of those four years, our country actually had a record high number of registered nurse candidates passing the NCLEX, registered nurse exam here in our country.

Sunny: Nice.

Amy: Each of those four years, we were graduating over 160,000 nurses who were passing the NCLEX exam. Even despite being at an all-time high of nurses passing the NCLEX exam and entering the registered nurse workforce, we still have unemployment rates that low. I think a lot of folks would say that yeah, there's a shortage. It's geographic. Interestingly, our government had put out a study on the nurse shortage, and they actually had said that, well maybe we won't have a nurse shortage, right. But I think that anybody who's in our industry and has been around in our industry even in the last five years would argue that no, sure feels like we're having a shortage.

Amy: I actually read that study in depth, and one of the interesting things that I noticed was that their whole shortage model was based on the assumption that in 2014, our nurse supply equaled nurse demand. But I think anybody in our country who is doing travel nurse staffing, or even per diem nurse staffing, would say that ... or even just being a healthcare recruiter would say, no, it did not feel like in 2014, we did not have a nurse shortage.

Amy: It does feel like it's going to be geographic, and it does feel like there's certainly a nurse shortage today, especially with such low unemployment rates. In the long term, in even looking forward out into 2030, it looks like the government is projecting that where there would be shortages, at least geographically, the largest shortages might be in places like in the west, in California. In the south, in Texas. Those are at least two of the areas or states that are expected to have a nurse shortage.

Sunny: Okay.

Matt: Fascinating, Amy. I think I know the answer to this question, but I think it's important. Much of our audience are travel healthcare professionals. You mentioned the overall state of nurses and allied health. Would you say that that is also the state for travel healthcare professionals? So the demand is near equal if not more for travel? Where that's concerned, in the current state?

Amy: Do you mean, is the shortage just as bad for some of the allied health professionals? Is that what you're asking?

Matt: Correct. Well, both for nursing and allied. I think that the audience would be wondering, yes the shortage is there overall, nationwide. But when it really comes to much of our audience, who are travel healthcare professionals, is there an equal demand, or is there even more of a demand for those types of folks? That are willing to pack up their lives for three months at a time and move across the country to help out a hospital?

Sunny: Yeah, especially with that, it's tight.

Amy: Yeah, I mean, just let me give you some anecdotal interesting points. In 2020, for travel nursing, the whole industry is expected to grow at 4%. One might feel like, wow, that 4%, it sounds like modest growth. But the reality is, that's actually higher growth than all of the other staffing sectors outside of healthcare. Healthcare is still growing at a relatively faster pace than even other industries within staffing. Allied health staffing is expected to grow by 3% in 2020. Locums, 4%, and per diem nursing 3%. We're still seeing pretty good year over year growth.

Amy: Then other anecdotes that I would point to is, I mentioned nurses and physicians earlier but I mean, PTs are expected to grow by 22% over this decade. By 2028, there's expected to be 302,000 employed physical therapists here in our country. Another anecdote would be, for nurse practitioners, by 2028 over a 10 year period, they're expected to grow by 28%.

Matt: Wow.

Amy: It really looks like across many of the different healthcare specialties, right, there's going to be strong employment in general in our healthcare systems. Folks have, and the BLS has been saying and projecting that certain healthcare settings are going to grow faster than others. For example, outpatient is expected to grow faster than say, hospitals as far as employment grows. Can you imagine that by 2028, the BLS is projecting that outpatient care centers, their employment will grow by 35%.

Matt: Wow.

Amy: Home healthcare will grow by 48%. Those are some really, really high growth rates, so that's really high even compared to hospitals, which are expected to grow only 6% for employment by 2028. But here's the thing. Despite the amazing growth that we're expecting to see in outpatient and home healthcare, the thing is, I don't think we can ignore the hospital setting. Because even at 6% growth, they're going to employ six and a half million people in our country, of which 3.7 million are going to be healthcare practitioners. That's why, I'm still thinking they're going to be the largest employer, even though the mix of employment is going to be lower at hospitals. In absolute numbers, they are still going to be one of the largest ... they're going to be the largest employer that we have in healthcare in the United States over the next 10 years.

Amy: It's not to be ignored. But in other parts of allied health, the projected employment is still expected to be in the double digits for say, clinical lab, lab techs, med techs, diagnostic techs, rad techs. They're all expected to grow in the double digits over the next 10 years. For people that are clinicians, I think it's a great time to be a clinician. Not just because of the robust job prospects, but also because it's such a rewarding career.

Matt: It's really interesting, when you put it that way, I think it is ... it's astonishing, the numbers are astonishing that you're talking to. It really sounds like if you're a healthcare professional within any modality, you really are ... if you want to work, there will be an opportunity to work. Not only that, there will be options of where you want to work. Depending upon the setting, you will be able to pretty much pick and choose of where you want to practice. Which I think is a really exciting time for people that chose to go into the field of helping people.

Matt: I think that that's really exciting for us too, especially our audience-

Sunny: I agree.

Matt: Who maybe they're not years from retirement, but they might be the students that you referred to, Sunny.

Sunny: Yeah. I agree with that. I think there's, you've thrown out a lot of numbers, and I think in layman's terms too, I think there's a lot of contributing factors. With, to kind of drill it down, you were talking about the growth of the outpatient centers. I think with the, I don't want to call it a fad because I'm hoping everybody's joining in the healthy train for longevity here. You're talking about people getting healthier, but also coming with that is injuries, you know. You're talking about people just working out, and I think with skilled nursing facilities and hospitals, that maybe cannot build as fast to take in all of the residents and the patients, and so home health is growing.

Sunny: I think there's reasons for all of this growth. But with this growth, it's coming at a faster pace, so I think with our listeners, am I right to say that travel is the reason why it's continuing to grow? Because when you're saying 4%, our listeners might say, "What does that mean to me?" I kind of want you to say in layman's terms, what does that mean to them?

Sunny: Then also, in your crystal ball, what changes can you predict for the nursing and allied industry? What's to come?

Amy: Yeah, it's interesting because when I say that healthcare staffing is expected to grow by 4% in 2020 alone, it could actually be even higher, except that the limiting factor of the growth is actually a lack of supply of clinicians.

Sunny: Got it.

Amy: There's actually more orders out there than what the staffing firms are able to keep up with, and put into placements. It actually could potentially be even faster.

Amy: But I think that one thing that our travel nurses and allied health professionals may want to be thinking about, and I think that they're already seeing it, is that there's a lot of change happening in the industry, driven by these healthcare trends. We talked a little bit about the outpatient setting before, even though hospitals will still be the largest employer. There really is a movement within healthcare, to drive care into the community, where the patient is. Into less costly settings, less acute settings. We want to get people the right kind of care for whatever condition they have, in their own setting, like in the right type of facility.

Amy: That is absolutely continuing to happen. We're going to see just more in outpatient. But I think that they'll also see just more technology coming our way, and impacting healthcare. It's already happening. Sometimes I think about things, like I ponder to myself, can clinicians and physicians ever be replaced by robots?

Sunny: Mm-hmm (affirmative). Yeah, and that's a good question.

Amy: Right, and because there's a lot of automation happening right now. There's new tech tools coming out, but there's also, artificial intelligence has been coming to healthcare as well. In the past, we've been seeing AI, right, artificial intelligence working behind the scenes in healthcare. It's been used to, say, assist physicians in providing patient care.

Amy: For example, right now we already have in some cases, artificial intelligence is helping to pre-interpret MRI scans, and detect possible cancer in imaging tests. They still absolutely want the radiologists to look at the images and make the call, so we're not totally relying on robots or AI to do diagnostics, right.

Sunny: That's good to hear.

Amy: But in the past ... That was very much a behind the scenes kind of thing. But now what we're starting to see is, even AI powered technology, it's going to come out from being behind the scenes, and it's going to start interfacing directly with patients to collect some of the initial information about their symptoms and vitals. One example of that is, there are these med clinics that have been opening in Safeway stores in Phoenix. A patient today can walk into one of those stores, can go up to a self-service kiosk, and can fill out a bunch of questions that talk about that person's medical history, their medications, their allergies, their symptoms.

Amy: There's even equipment that they can use to self-diagnose. There's a stethoscope, there's a thermometer, there's a blood pressure machine. They can have images or pictures taken of the patient's throat and their ear and their nose, and then all of that gets uploaded into this kiosk. Even though there's a medical assistant on standby to help if it's needed, there's no onsite physician or nurse in that clinic.

Amy: The kiosk collects all that information, and it can even eventually ... actually, I think it's happening. They're using the AI to look at that information and make a pre-diagnosis. But then what happens is, you're at the kiosk, and a real clinician, like a nurse practitioner or physician, actually comes online, right, and then joins you. Now you're having a live interaction through this kiosk, and ultimately that clinician is making the call on what your diagnosis is. But a whole bunch of stuff was done where the patient him or herself interacted directly with technology to get that process started.

Amy: Once the actual physician or NP makes the diagnosis, they can write a prescription, and you can literally just go to that pharmacy that's right there and have your prescription filled. These are interactions that are happening in less than half an hour, right? You walk in, you can actually get examined within half an hour. You can have your prescription filled out, and if you don't have insurance, you can get this done for about $75, right? So the healthcare world is trying really hard to bring it to you, to the community, to make it easy through technology.

Sunny: No-

Amy: So that's happening. But you can see that the nurse and the physician is not being replaced, right? And you know-

Sunny: Yeah. But I can see some pros and cons to that, Amy? Sorry to interrupt.

Amy: Mm-hmm (affirmative). Yeah.

Sunny: My challenge with that is that, I think of, especially with different cultures. I come from an Asian culture, and it's already tough enough to get my mom to the doctor. But also, you give them, my mom into something like that, she's going to take it. But the problem is, you get someone who is very resistant to a medical professional to go and use something like that, they might miss some really important or high-risk diagnosis. They might risk some simple symptoms that maybe are chronic, or something that is dangerous. They might just go in for the easy stuff. But then that kiosk isn't going to tell you that this is something that has been going on all the time.

Sunny: Then the other thing I have is, everything is hackable nowadays. It just seems everything is hackable. I don't know, I mean, call me naïve, but that's just something that to me, it is just high risk. I don't know. That would be a great discussion or a debate for a panel sometime. We should think about that.

Amy: Yeah, that would be something that would be great to explore. Because cybersecurity has always been a huge issue in healthcare, so that's something that we absolutely ... The healthcare systems are going to continue to focus on that, because of its importance.

Amy: Regarding the diagnoses piece of it, I think that that's why we're still having clinicians ultimately make the diagnostic call. We're not over-relying on technology to make that call. We should look at it as, the technology is there to supplement the diagnosis. It's not there to actually make the diagnosis. There's also some elements of AI that ... AI, it's just not sophisticated enough at this point to do certain things, like show empathy, or compassion.

Sunny: Yeah, exactly.

Amy: Right? Which is very needed in a patient interaction, and it's also not ... AI has not reached a point yet where it can actually show common sense. Those are all reasons why we would not over-rely on the technology for the diagnosis. But we should think of it as a very powerful and helpful way to supplement these diagnoses. It's more to help figure out who might be at highest risk for certain things.

Amy: The other important thing about technology, and this goes outside of AI is, telemedicine has been around for a long time. But we'll probably continue to see an embracement of telemedicine over time. In 2019, a survey was done by Rock Health and the Stanford Medicine Center for Digital Health. They did a survey of 4000 US adults, and they found that about a quarter of them had used live video telemedicine over the past 12 months.

Amy: It is happening, it is getting adopted. The VA is actually also accelerating their use of telemedicine, so they actually in May of 2018, the VA, they came up with an Anywhere to Anywhere initiative, where they sort of removed the barriers to state licensing requirements for the VA providers. But you know what, it resulted in telemedicine being used by 17%, it was a 17% increase in telemedicine usage by veterans. Sometimes lifting these barriers can be helpful.

Sunny: Yeah.

Amy: The VA's program is sort of like a first step, in terms of sort of role modeling this kind of national medical practicing, licensing concept. We don't really know where that's going to go, but you know, it's a positive good first step to observe.

Sunny: Yeah. Like I said, I can see some pros, and I can see some cons. The pros is, is you're meeting the patient where they're at. That is a pro. But there are some cons, and like I said, I think it would be a great discussion that maybe we can talk about ... I don't know, what do you think, Matt, to do a panel discussion in the future about?

Matt: Well, I nerd out about technology. I could talk for days about it.

Sunny: Yes you can.

Matt: But I want to ... I think it's interesting, and without a doubt, there is ...

Sunny: Have you back.

Matt: We could talk for days. I kind of want to circle back a little bit, to what you see Amy when you're talking about, what's the next big things? Because I think this technology, I'm all about the access. Especially piloting programs that allow people to get healthcare where they're at. That to me is exciting, and I think we could come and we could talk for days. But when it comes to the next big things, one of the things we saw in the therapy world was PDPM. You mentioned, you alluded to that a little bit earlier, Amy, that was a little bit of a bump in the road for therapy. But getting through that.

Matt: What are some of the next big things? It doesn't have to be allied-specific or nursing-specific, but some of the things that you see right on the horizon, that you would say, this is going to affect either positively, or maybe not so positively affect the industry?

Amy: Well, PDPM came into play on October 1st, and that did impact therapy in the skilled nursing facilities. The next one after that was the PDGM, which was going to impact similarly in the home health world. That's set to start on January 1st. My guess is, they're sort of similar impacts in reimbursement rates for those facilities. They could have similar impacts. There were quite a few anecdotal instances of therapists having their hours reduced, or even having some layoffs.

Amy: But you know, when you take a step back and you look at the bigger picture, a couple of things to think about. One is that these reimbursement rate changes and shifts from minutes or from volume reimbursements to value based reimbursements, this has been happening for some time. This is not the first time that the therapists have been sort of disrupted like this. They survived, for sure. It could continue to happen from time to time.

Amy: But what I will say about for example with physical therapists. I once had this amazing opportunity to shadow a physical therapist who was a home health physical therapist. I followed her around to her patient interactions for a day. When you see the impact that they have on the patients, and you realize wow, this must from a health perspective, and a healing perspective, this has such a tremendous positive impact on patients. When you see that, it's almost like you realize that this is going to remain strong forever. Because it's an essential part of care, right?

Sunny: Yeah.

Amy: It makes such a huge difference. I'm pretty sure that that's why, despite these little bumps in the road, the projections of these physical therapists in the long term ... I mean, they're I believe expected to grow ... I think I earlier said 22% over 10 years, right? When you see a physical therapist actually in action with a patient, it's not hard to sort of believe this.

Amy: That's, to answer your question around the disruption. I think it'll be fine, and these reimbursement rate things will likely continue to happen over the long term, especially around bundle payments initiatives. It'll continue to happen. There'll probably continue to be small disruptions. But I think that at the end of the day, the clinician always make the comeback, right?

Sunny: Yeah.

Amy: Because they're just so, so needed in our healthcare system. I think, you know another trend that's very interesting, and this is sort of going back to technology versus reimbursement rates. I just also want to point out that as far as technology goes, the technology will also hopefully make the clinicians' work even better. What I mean by that is, so for example right now, sometimes nurses, they do some pretty arduous hard work. I mean, they have to lift bodies. It takes quite a bit of strength to do that. It can be very tiring, especially in a 12-hour shift. You actually have to physically be in good condition to be a nurse.

Amy: Places where robots can come in and really be helpful to the nurses in delivering patient care. So for example, there will be exoskeleton robots that can come and actually do some of the heavy lifting for us, right? That just makes a lot of sense, because we don't want to have nurses out there with workers' comp injuries. We want them focused on delivering care, and not necessarily lifting bodies all the time.

Amy: Those are examples of repetitive tasks, right, or where perhaps we can alleviate some of the nurses' responsibilities and allow them to really focus on the patient care and being at the bedside. Those are some important things to think about. Another one is, in surgery there's robots that are ... not robots, but there's technology that's coming out that's going to make it very helpful for surgeons to do surgery more precisely. Faster, with better patient outcomes. Then the surgeons can take more breaks, and they're not standing there in the same position-

Sunny: For hours.

Amy: For hours and hours on end. That should help our surgeons to have fewer workers' comp injuries, or fewer neck injuries from having to hold themselves in the same position for so long.

Amy: A lot of this technology will also I hope help the clinicians themselves. I know other examples are-

Sunny: And also help the hospitals, right?

Amy: There's robots that will do disinfections, right? That's another area where a robot could be superior to a human, and that's less about patient care.

Sunny: Mm-hmm (affirmative). But also help out the hospitals, when we're talking about FMLA and medical costs in that way?

Amy: Yes. Yes.

Sunny: Mm-hmm (affirmative). We've covered a lot today, definitely I kind of want to wrap it up with what we've covered. Lots of ... What I'm gathering is that we're not going anywhere. The travel, there's always going to be a need. There's growth in the allied and nursing fields with growth being predicted by the BLS in both markets.

Sunny: But also for travel, even though unemployment have really really low numbers, the travel needs are there, whether it's geographic based. Anything else that you can wrap up for us, just to kind of help our listeners out there?

Amy: Yeah, you know, the only other term I would point out is, there's a possibility that temporary staffing of healthcare clinicians continues to grow, simply because it feels like our population at large is becoming more and more interested in this gig economy type of work. As our whole population embraces it, it's possible that our workforce might shift, and in that regard travel nursing and travel allied, or even just per diem assignments become more and more popular across our healthcare practitioners, just because of this interesting trend for the gig economy in our overall population.

Sunny: Yeah.

Matt: Amy, we've discussed a lot of exciting things in the industry right now, and I think the technology, the future is certainly bright when you start talking about the technology, about the demand. But if you were to break it down for traveling healthcare professionals today, what would your advice be? Really your expertise, what would your advice be to those folks? I think that would be the question that we would want to ask.

Amy: Okay. I think the advice that I would have for clinicians who are considering taking a travel assignment or doing some temporary work ... it's a really exciting time, and let's say you've got two years of experience under your belt in an acute care setting. But if you're relatively new in your career, it might be a good time in your life to take a look at what other hospitals or settings you could go and try, right. You could use a travel position as a way to explore different geography in our country, to explore a different kind of setting, or perhaps there's a prestigious facility and this is your chance to get in there. It's a great way to see lots of different hospitals and healthcare systems, and the way they do things and what their best practices are.

Amy: I think that's one of the most powerful things that a clinician can get out of having a travel experience or a temporary experience, is just the chance to experience how other systems do things. I think that's a great way to build your career and have some just very cool facilities on your resume.

Matt: That's great advice. Much of the need across the country is a rural setting.

Sunny: Exactly.

Matt: Where it may not necessarily be the most prestigious environment, but it certainly is no less important for the community. Especially some of these smaller communities that are desperate for clinicians to come in there and deliver the best healthcare they can. That's huge.

Sunny: Yeah.

Matt: So maybe we can talk a little bit, or Amy, you can talk a little bit about the rural settings, and the need for travel healthcare professionals in those settings as well.

Amy: Yeah, there's a huge need for healthcare practitioners in rural areas. That's why there's a lot of interest in telemedicine. But I think every rural community would actually prefer to have an actual clinician in their town, delivering great care to their community.

Amy: Temporary staffing, these assignments, I mean it's a great way to go be a part of a different community and explore different geography. But also, have a really positive impact on that community. Because the newer generation, they really care a lot about making a difference. Part of their career has to be sort of mission-focused, and they really, really want to make a positive difference. Going into a rural community, at least for some period of time, can make a difference. It could really feel personally rewarding as well.

Amy: So I think that again, it's another opportunity to explore different parts of your career, different things to do as part of your career, and just accumulate really amazing experiences. It's a great way for clinicians to just take a look at, how can I expand that and diversify my set of experiences? I think trying different communities is a great way.

Sunny: I think that's great, and just to add on to that, is also a great way to probably fine-tune some skills, because I find that clinicians going into rural areas, they need to have a certain type of finesse, because your patients tend to be a little bit more conservative. You really need to be able to meet ... Those are those patients that you really need to meet them where they are.

Amy: Mm-hmm (affirmative).

Sunny: So if we're talking to travelers and also talking to managers, you really need to be able to learn your communication skills, your cultural skills. Just all types of skills, and so for those clinicians and travelers that are looking to move upward, and that mission seeking that you're talking about Amy, rural is where it's at.

Amy: Very true, because as we said before, right, clinicians are unlikely to be replaced by robots.

Sunny: Yeah, yes.

Amy: Because it's that bedside manner, the compassion, the empathy, the common sense, right? That only a clinician can really provide.

Sunny: Well, I really, really appreciate you being here. Lots of information. I know that our listeners are probably going to want to have you back for that panel discussion, especially learning so much. Probably for us to learn more about AI and the future of that, and telemedicine as well. Matt, do you have anything?

Matt: Yeah, thank you Amy, for stopping by. I know you're very busy with SIA. You do great work at SIA.

Sunny: Amazing.

Matt: So thank you very much for taking the time with us. Before we let you go, we like to ask all of our guests a very simple question at the end. Amy, what is your why?

Amy: For me, I've found throughout my career that the thing that makes me happiest is helping other people achieve their own personal and professional goals. I've always been a huge mentor to people that I meet. I love being a sounding board and a mentor, because I just simply love watching people achieve their dreams, and live out their dreams. It absolutely ... that's literally the thing that makes me happiest in life, and so I feel like that's why being in this SIA role is sort of ideal for me. Because I came from the healthcare staffing industry, it's where I advanced my career. I really, really have a fondness for the healthcare staffing industry in general. The ability to help all of the staffing companies in our industry continue to grow and helping the business owners achieve their goals, I mean, that actually really, really makes me happy, and that's why I enjoy this so much.

Amy: Likewise, seeing clinicians and physicians be able to fulfill their own personal dreams and goals and be a part of this healthcare system. The whole thing just sort of drives me and makes me happy.

Matt: We also love to hear the whys from the travel healthcare community. Let's listen in.

Nathan: Nathan Abbott. I'm a radiology traveler. I travel because it gives me the freedom and opportunity to see new places and meet new people and experience new things. I figured that this would be an opportunity to be able to do that when I'm younger, instead of waiting until I retire.

Sunny: We love to hear from our listeners, so thanks again for listening. Please drop us a review, and let us know what your thoughts are on today's topic, or anything else you'd like to discuss. And as always, thank you, Matt.

Matt: Thank you, Sunny. Bye-bye, everybody.

Sunny: Bye, everyone!

Voice Over: You've been listening to Cardium, from Aureus Medical, with your hosts Sunny and Matt. We're the podcast that gets to the heart of travel healthcare. To subscribe, access show notes, or to learn more, visit cardiumpodcast.com. C-A-R-D-I-U-M podcast dot com. Or wherever you're listening, be sure to rate us, review, and subscribe. Thanks for tuning in. Until next time.

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